The Effect of Empathy Training on Bullying Behavior in Juvenile Prisoners: A Quasi Experiment.

Purpose: The purpose of this study was to determine the effect of empathy training on bullying behavior in juvenile prisoners at the Bandung City Special Development Institute for Children. Methods: This study used a quantitative method with a quasi-experimental design with pre and post-test with control group. The sampling technique used purposive sampling and obtained a sample of 100 respondents (50 intervention group and 50 control group). Empathy training was conducted for 3 months as many as 4 sessions consisting of education, role play, watching movies, and reflection. Data collection used the Indonesian version of the Olweus Bully/Victim Questionnaire. Univariate analysis used mean, min-max, and standard deviation values. Bivariate analysis used Wilcoxon test and Mann-Whitney test. Results: The results showed that in the intervention group, most respondents had high bullying behavior before the intervention (70%) and had low bullying behavior after the intervention (64%). In the control group, most respondents showed a high level of bullying behavior (80%) at pre-test and had high level of bullying behavior (78%) at post-test. The results of the Wilcoxon test showed ap value of <0.001, indicating that there was a significant effect on reducing bullying behavior in prisoners in LPKA Bandung City after being given empathy training. The results of the Mann-Whitney test showed a value of p<0.001 which means that there is a difference in the level of bullying behavior between the control and intervention groups. Conclusion: Empathy training is a recommendation for community nurses in Bandung City Special Development Institute for Children to implement community-based nursing interventions in preventing bullying in children and adolescents, especially adolescents in prison.

Effect of empathy training on the empathy level of healthcare providers in Ethiopia: a cluster randomized controlled trial.

Objective: Empathy has deteriorated throughout clinical training and medical practice, and little is known about the effect of empathy training on the empathy level of healthcare providers. To address this gap, we assessed the effect of empathy training on the empathy level of healthcare providers in Ethiopia. Design: A cluster randomized controlled trial study design was conducted from 20 December 2021 to 20 March 2022. The empathy training intervention was conducted for three consecutive days. Setting: The study was conducted in five fistula treatment centers in Ethiopia. Participants: The participants were all randomly selected healthcare providers. Main outcome measures: Total mean score, percentage changes, and Cohen's effect size were computed. A linear mixed effects model and independent t-test were used for data analysis. Results: A majority of the study participants were nurses in the profession, married, and first-degree holders. There was no statistically significant difference in the baseline empathy score of the intervention arm across their socio-demographic features. At the baseline, the mean empathy scores of the control and intervention arms were 102.10 ± 15.38 and 101.13 ± 17.67, respectively. The effect of empathy training on the total mean score changes of empathy of the intervention arm compared to the control arm at each follow-up time had a statistically significant difference. After a week, a month, and three months of post-intervention, the total mean empathy scores between the intervention and control arms were as follows: (intervention 112.65 ± 18.99, control 102.85 ± 15.65, d = 0.55, p = 0.03); (intervention 109.01 ± 17.79, control 100.52 ± 12.57, d = 0.53, p = 0.034); and (intervention 106.28 ± 16.24, control 96.58 ± 14.69, d = 0.60, p = 0.016) with the overall percentage changes of 11, 8, and 5% from the baseline scores, respectively. Conclusion: In this trial, the empathy training intervention was found to have more than a medium effect size. However, over the follow-up intervals, there was a decreasing trend in the total mean empathy scores of healthcare providers; suggesting that there should be continued empathy training and integration of it into educational and training curriculums to enhance and sustain the empathy of healthcare providers.Clinical Trial Registration: Pan African Clinical Trial Registry: http://www.edctp.org/panafrican-clinical-trials-registry or https://pactr.samrc.ac.za, PACTR202112564898934.

Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators.

BACKGROUND: Amid concerns about the decline of empathy during the clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential alone cannot, however, guarantee the success of educational innovations to introduce empathy to the medical curriculum. This research aims to identify the barriers and facilitators of the implementation of a specific clinical initiative to enhance the empathy skills of clerks, namely the training of clerks to act as a 'MedGezel' or 'medical coach'. METHOD: We conducted an explorative qualitative study based on interview data collected and analyzed using reflexive thematic analysis and the readiness for change theory. We conducted semi-structured interviews with relevant stakeholders in this particular qualitative study. Thematic analysis was based on open and axial coding using ATLAS.ti 9, which facilitated the emergence of common themes of interest and meaning for the study. RESULTS: A total of 13 relevant stakeholders participated as interviewees in our study. The data was collected from April to June 2021. Our analysis generated 6 main themes which can provide insights into why the implementation of the MedGezel educational innovation failed so far. The following themes emerged: the case for change: why change?; practical necessity; leadership; management and resources; staff culture; and alignment with the corporate strategy. DISCUSSION: The implementation failure can be partially explained as resulting from the personal attitudes and choices of participants, who struggled to reconcile a vision that they liked with side effects that they feared. While participants repeatedly mentioned management and leadership issues, these organizational issues seemed less important as they could be easily resolved in practice. What was more important and fatal for the initiative was its lack of alignment with staff culture, despite its alignment with corporate strategy. CONCLUSION: This investigation into the barriers and facilitators influencing the implementation of the MedGezel program identified 6 explanatory themes, the most impactful one being staff culture.

The effectiveness of empathy training in health care: a meta-analysis of training content and methods.

OBJECTIVES: The meta-analysis examined the question of whether empathy training is effective in health care and whether specific training content and methods can be found to account for its effectiveness. METHODS: We included 13 out of 50 studies (total N = 1315) that fulfilled the search criteria. R version 4.0.5 with the esc, meta, metafor, and dmetar packages and SPSS28 were used to conduct the meta-analysis based on the random-effects model. The effect sizes were calculated using Hedge`s g, and heterogeneity was tested using Cochran's Q. In addition, the multicollinearity of the moderators was checked. RESULTS: The overall effect size (Hedge´s g = 0.58, s = 0.10, p = 0.00) indicated a moderate effect of empathy training. There was a significant heterogeneity (I2 = 76.9%, Q = 84.82, p=0.00), thus we examined whether individual training methods have influenced effect sizes, which could not be confirmed (F (8,4) = 0.98, p = 0.55). The same applied to the training contents (F (6,6) = 0.27, p = 0.93). CONCLUSIONS: The present study showed that empathy training could be effective. This confirmed previous findings and supported the use of such training. However, according to our results, no significant moderators could be found, i.e., the training contents or methods did not contribute to the effect sizes. For meaningful findings, a comparison of different training components should definitely be made, and it should be investigated whether empathy training spread over a period of time is more effective and sustainable than one-time training.

"Brought to life through imagery" - animated graphic novels to promote empathic, patient-centred care in postgraduate medical learners.

BACKGROUND: Empathy levels decline through medical training. This has been associated with poor patient and physician outcomes, and strategies to combat this decline are increasingly recognized as critical aspects of medical education. The aim of this study was to qualitatively determine factors associated with empathy decline, and to assess the impact of a comics/graphic novel-based curriculum on enhancing empathy and a patient-centered approach to care in post-graduate medical learners. METHODS: Fourth and fifth year residents in the Adult and Pediatric Endocrinology and Metabolism Program at the University of Toronto were recruited from the 2017 cohort of the Empathy, Humanism & Comics course. Participants completed a 12-month curriculum, viewing a total of four animated graphic novels over six sessions. At the end of the course participants were interviewed either individually or in a focus group. A coding framework of emerging themes was developed based on consensus between the three authors using a qualitative descriptive approach and the constant-comparison method. RESULTS: Analysis of coded interview data revealed four themes. 1. The curriculum accurately reflected and addressed issues in real world medical practice; 2. The comics curriculum facilitated holistic development; 3. Participants appreciated the comics as an educational medium; 4. Participant feedback on the curriculum. The importance of empathy was noted, while participants acknowledged their own empathy decline and increased burnout. Stressors included increasing responsibility, long work hours, and competing work-life responsibilities. They felt the sessions developed resilience, an appreciation for the patient perspective, and communication skills. They appreciated the comics as a novel and engaging educational modality. Feedback on the effectiveness and relevancy of the curriculum was variable. CONCLUSIONS: Residents appreciated sharing difficult experiences and seeking support. They acknowledged the curriculum as a commitment to wellness and felt it reduced burnout and improved empathy. The comics were viewed as an effective reminder of the patient perspective. Variable curriculum feedback highlights the challenge in designing a course for adult learners. Future investigations may include the development and incorporation of similar curricula in other post-graduate residency training programs.

Improvement of Medical Students' Empathy Levels After an Intensive Experiential Training on Empathy Skills.

Background: EMPATHY IN HEALTHCARE is an intensive 20-hour experiential training program based on mediation techniques and specialized healthcare role-play for clinicians and medical students. It is hypothesized that the training will improve empathy via the intensive experiential techniques implemented. Methods: A total of 50 medical students (25 males/25 females) took the course voluntarily. Empathy was measured using the Jefferson Scale of Empathy-Medical Students Version (JSE-S) (Greek version), before and after the 20-hour training, along with a 6-month follow-up. Gender, age, preferred medical specialty and baseline empathy score were explored as possible moderator variables of the training effect. Results: Empathy increased after training, with a mean JSE-S score improvement of 11.25 points (±8.848) (P < .001). After 6 months, the mean JSE-S score maintained a difference of 6.514 points (±12.912) (P < .005). No differences were recorded with regard to gender, age group or medical specialty for the pooled data. Women in the 22-24 year-old age group had a 5-point mean difference (P = .05), and higher post-training scores than men. Lower initial scorers were the ones that mostly improved, with a 3-fold mean score difference from the higher scorers regardless of gender (P < .001), while also showing a smaller drop in empathy levels 6 months after the training compared to the higher scorers. Conclusion: Intensive experiential training can improve empathy in a clinical setting. EMPATHY IN HEALTHCARE is a successful training program in improving empathy in medical students, as measured by the JSE-S. A score of 110 and below could be used for selecting medical student candidates who will benefit most from empathy training.

Development and Validation of a Novel Measure for the Direct Assessment of Empathy in Veterinary Students.

Empathy is a requisite clinical skill for health professionals and empathy scores have been positively associated with professionalism, clinical competency, confidence, well-being, and emotional intelligence. In order to improve empathy in the veterinary field, it is critical to measure the construct of empathy accurately. Most research has relied on self-reporting measures to assess empathy, while some studies have recently implemented the use of simulated client encounters in veterinary education. Building on this research, the aim of the current study was to develop and validate a novel quantitative assessment tool-the Empathy Clinical Evaluation Exercise (ECEX)-designed to measure empathy based on directly observable behaviors, using simulated clients. To evaluate empathy, evaluators used the ECEX to assess the performance of student clinicians in a simulated client encounter, which contained a pre-determined number of opportunities designed to elicit empathic responses from student clinicians. Statistical analysis suggests the test has a high degree of inter-rater reliability. In addition, there was moderate correlation between average empathy scores using ECEX and previously validated measures of empathy, compassion satisfaction, and burnout. Using these methods, we found the majority of students we studied had increased empathy scores at the completion of their primary care rotations. These results provide preliminary support for the use of the ECEX as a direct and quantitative tool for the assessment of empathy. Health professionals could use this novel empathy assessment tool to teach students, evaluate teaching strategies, and improve communication competencies in a wide variety of clinical settings. Our broad aim was to examine the utility of a direct and quantitative assessment tool for measuring empathy-the ECEX-in order to answer the following questions: (1) Does the tool have good inter-rater reliability? (2) Does the tool correlate with previously validated empathy measures? and (3) Does the tool correlate with similar constructs of compassion fatigue and burnout? Our secondary aim was to evaluate the change in empathy scores over the course of a 4-month (16-week) primary care rotation (pre- to -post).

Impact of an Empathy Training Program on Children's Perspective-Taking Abilities.

This study investigated the impact of an empathy training program developed by the researchers to promote perspective-taking abilities of preschool children. Participants were 34 children from two different kindergartens. Children in the treatment group attended an empathy training program that consisted of 30 activities and lasted for 10 weeks, whereas those in the nonintervention group attend the regular preschool program. Data were obtained through individual interviews with children. Perspective-Taking Test for Children, designed by the researchers, was used to assess children's perspective-taking abilities. The results of the study demonstrated that the training program significantly improved perspective-taking performance of children in the treatment group compared to their peers in the nonintervention group, and this effect persisted one month after the intervention.

The effectiveness of empathy training on the empathy skills of nurses working in intensive care units.

BACKGROUND: Empathy is an essential condition for effective nursing care. An empathetic relationship between the nurse and the patient leads to positive therapeutic outcomes, increases nurses' adjustment in educational and therapeutic environments and influences their ethical sensitivities. AIMS: The current study aimed to determine the effectiveness of empathy training on the empathy skills of nurses working in intensive care units of Shahid Bahonar Hospital in Kerman, Iran. METHODS: This experimental study was conducted on nurses working in intensive care units of Shahid Bahonar Hospital affiliated to Kerman University of Medical Sciences in Iran. All nurses working in intensive care units of Shahid Bahonar Hospital were selected by randomised sampling. Data were collected by the Davis Empathy Scale (possible range 0-105) and analysed using descriptive statistics and analysis of variance. RESULTS: Comparison of the mean empathy scores showed the mean scores of empathy skills in the control group were 63.45 ± 8.102 and 63.54 ± 8.05 in the pre- and post-test, respectively, which was not significantly different. But the mean scores of empathy skills in the Experimental group were 63.40 ± 8.136 and 67.7 ± 9.027 in the pre- and post-test, respectively, which showed a significant increase (p < 0.05). CONCLUSIONS: The present intervention showed the effectiveness of empathy training on the empathy skills of nurses. Empathy can be acquired and learned.

[Empathy in medical students in the Republic of El Salvador: Cross-sectional study]. / Empatía en estudiantes de medicina de la República de El Salvador: estudio transversal.

OBJECTIVE: To evaluate empathy in medical students of the Evangelical University, Republic of El Salvador. MATERIAL AND METHODS: A cross-sectional study was conducted in which empathy levels, as well as the reliability of the data, were measured in 640 students. The mean and standard deviation were estimated in two factors: gender and courses studied. The data were processed using bi-factorial variance analysis (modeliii), calculating the effect size, power of the test, and the possible growth potential of the empathy and of each of its components considering the gender. The level of significance was α≤.05 and ß≥0.80. The SPSS 22.0 statistics program was used. RESULTS: Differences were found between courses and gender. The differences between courses in empathy are due to values by males in specific components. The model of decline in empathy and in the component, compassionate care, is not fulfilled. CONCLUSIONS: The levels of empathy between the genders were higher in males than in females, and similar in the compassionate care component. This is not consistent with the idea that women have higher levels of empathy than the men. There are differences in the behaviour of the means depending on the course and gender, and the empathy decline model is fulfilled only in two of its components. The characteristics indicated constitute the diagnosis of the empathy situation and constitute a guide to construct an intervention.

Impact of a fictional reading intervention on empathy development in student pharmacists.

OBJECTIVE: Determine the impact of a short longitudinal literary fiction intervention on empathy development in student pharmacists as measured by the Jefferson Scale of Empathy - Health Profession Students (JSE-HPS) version. METHODS: Twenty-one student pharmacists were randomized to an intervention consisting of reading short excerpts of literary fiction over eight weeks (n=11) or a control group not participating in the intervention (n=10). Both groups completed the JSE-HPS at baseline and completion of the literary intervention. Categorical data were compared using a chi-square or Fisher's exact test, and continuous data were compared using paired or independent t-tests for within and across group comparisons respectively. RESULTS: JSE-HPS scores increased in the intervention group (112.1±10.7 to 116.1±7.4; p=0.201) while they decreased in the control group (118.7±12.6 to 113.0±15.9; p=0.188). Changes across groups were not statistically significant (p=0.061). CONCLUSIONS: Students randomized to an eight-week literature intervention demonstrated a non-statistically significant increase in empathy as measured by the JSE-HPS questionnaire. Similar increases were not observed in students randomized to a control group. As a result, this intervention may represent a novel way to foster empathy in student pharmacists using an intervention requiring few resources. Further research is needed with larger sample sizes, ideally across multiple institutions, in order to validate the effectiveness of this intervention.

A randomized prospective study on outcomes of an empathy intervention among second-year student pharmacists.

OBJECTIVE: To determine the impact of a single, 3-day intervention on empathy levels as measured by the validated Jefferson Scale of Empathy-Health Profession Students version (JSE-HPS). METHODS: Forty second-year student pharmacists were recruited to participate in a non-blinded prospective study. Subjects were randomized to an intervention group (n=20) or control group (n=20) and completed the JSE-HPS at baseline, 7 days postintervention, and 90 days postintervention. The intervention group consisted of a 3-day simulation, each day including a designated activity with loss of dominant hand usage, vision, and speech. RESULTS: The 3-day simulation increased empathy levels in the intervention group compared to the control group 7 days postintervention (p=0.035). However, there were no effects on empathy levels 90 days postintervention (p=0.38). CONCLUSION: Empathy scores increased but were not sustained in the long-term with a 3-day empathy intervention.

The effects of empathy training intervention on the empathy and emotional intelligence in new employed nurses / 中华行为医学与脑科学杂志

Objective To explore the efficacy of empathy training on the empathy and emotional intelligence in new employed nurses (engaged in clinical work within one year).Methods A total of 82 participants were randomly divided into the intervention group and the control group (n =41).The intervention group was conducted with empathy training in addition to routine clinical guidance,the control group was only conducted with routine clinical guidance.All subjects were assessed with the Interpersonal Reactivity Index (IRI-C) and Emotional Intelligence Scale (EIS) before and after intervention.Results Immediately after the intervention and 3 months after intervention,the scores of IRI-C in the intervention group were significantly higher than those of the control group((57.53 ±5.20) vs(50.50 ±7.64),(55.28 ±6.48) vs(46.90 ± 7.74),P ＜ 0.01).Samely,the scores of EIS in the intervention group were significantly higher than those of the control group((131.55 ± 10.49) vs(124.35 ±9.93) ;(126.27 ± 12.87)vs(119.38 ±9.45),P＜0.01).Conclusion Conducting empathy training can improve the empathic ability and emotional intelligence of new employed nurses.